To Rehab and back

Addiction is often viewed as an externalized problem. A problem that only happens to 'others'. But for those who go through it, or see their loved ones suffer, the notion seems ridiculous. Addiction, particularly substance use, can be a hellish experience for the person and their family. After initial attempts fail, the way to recovery for many is through rehabilitation centres. But as many like me would attest, people coming out of these rehabs may need another kind of recovering altogether.

It is common knowledge that patients are mistreated in the rehab centres. I know it particularly intimately because I suffered with the problem of addiction and my family, out of love no doubt, had me taken into a rehab. In fact, I am one of those lucky ones that had a family which cared and was financially strong enough to afford rehab costs. Thousands, if not hundreds of thousands, neither have the family or the support or both to send them to rehabs.

But where do people with such grievous affliction as addiction get sent for recovery? There are now many narcotics addiction treatment centres or rehab across Bangladesh, although mainly in the cities. But a large number of these, if not most, lack a scientific and medically sound approach towards how to help people come out of addiction.

It all starts with a group of strangers apprehending a patient forcefully. It is true that sometimes it becomes necessary to take an addicted person to the rehab facility and consent can't be taken in any meaningful way. A host of legal questions, nevertheless, arise regarding delegation of authority and so on. Leaving that aside, what is obvious is that the current practice in Bangladesh does not use this as the last resort. It is further compounded by the fact that desperate families often empower the rehab to take the action of basically kidnapping, albeit for the captive's own good. But it doesn't feel good for the person that goes through this truly traumatic experience. And that's not just because you don't get your fix.

Once taken into the premise I landed in a room of around 300 square feet (the in-house) packed with thirty other patients. There's not much expected of you other than compliance with few dozen in-house rules. But there are other things that I struggled with. A group of thirty people were allowed to use only one washroom. We got meals three times a day. The food was barely sufficient and not filling at all. We could often clearly see our faces on the steel plates. The food was not nutritious and often times, we would find roaches or bits of them in our meals. And then comes the healthy dose of mental torment through harsh intimidating behaviour. Abusive words were used liberally with no apparent thought of the patients' mental well-being. All for only Tk25 thousand per month that my family was paying.

Admittedly some discipline is necessary, but without compassion and understanding, added with cruel behaviour makes the rehab experience scar on your mind that does not heal easily. A full year after being released from the rehab, one of my fellow patients, who is a friend too, still has nightmares and cannot sleep thinking someone might bust into his house.

Half way through his time there, he started suffering from a physical disability and could not carry out any activities. Whenhe requested the officials to get him proper medical treatment, they ignored him. Instead he was accused of faking his illness. After a month his family got to know about his condition on the family-visit day and they demanded to take him into a hospital. But the rehab management fought with the family against this and they had to argue with them until they agreed. But they put two men as guards from the rehab at the hospital.

My friend was diagnosed with hernia and testicular cyst, which was on the verge of developing into cancer. His operation and subsequent treatment went on for nine days and on the tenth day, he was forced back to the rehab on basis of a promise made by the management to the family that they will take proper care of him and will make sure he does not suffer physically. Having two big cuts on his body, he had to stay in a clean environment. Sadly, the place he was in does not fall in the standards of cleanliness and hygiene. On top of that, few days after his return, he was ordered by the owner of the rehab to wash his personal car and clean bird cages. When he tried to refuse on health grounds, they insisted saying this was necessary for his sobriety. He ended up getting infections and faces problems to this day. He says this as a direct result of the negligence and lack of standards in that rehab.

There are other bad practices as well that take place in the absence of a proper monitoring authority. During Eid-ul-Adha, a patient's family was insisted into paying Tk50 thousand to buy the 'biggest raam chagol', just to achieve a supposed 'victory' over a competing rehab centre. Because the family was well-off they took advantage of that. And playing fast-and-loose with payment was also part of how much they charge for the stay. My family paid 25 thousand taka, but that's not what they charge others necessarily. They try to take as much as they can if the family is rich. I have also seen them trying to to extend the stay of patients, which happened in the case of my a fellow patient who had to five more months than initially stipulated.

I suppose families know that people are not exactly treated like guests in luxury hotels in these rehab centres. But most probably don't really understand the psychological impact of this experience. And once you come back it probably seems even less important for them to try to understand. But it stays with us. The situation cannot change if there is not concerted effort from the government and proper regulations aren't put in place. And if it doesn't change then people like me, my friend and many other will continue getting sent into rehab and continue coming back with damaging experience.